Workshop Request | Humber Counselling

Workshop Request

Please fill in the following form with as much information as available.

Name: *

Extension: *

E-mail: *

Workshop topic: *

*Workshops with (+) require 2 periods, and have a per person fee for materials.

Expected Outcome of workshop: *

CHOICE1

Preferred presentation dates: (please list 3 possible dates) *

Date: *

Time: *

CHOICE2

Date: *

Time: *

CHOICE3

Date: *

Time: *

Academic Program:

Course Name:

Semester:

Group Size:

Campus/Room Number:

Emergency